What Is Eczema (Atopic Dermatitis)? Symptoms, Causes, Diagnosis, Treatment, Prevention

Eczema is not a specific disease, but rather a term that describes a group of inflammatory skin conditions that produce rash-like symptoms, such as red, itchy patches on the skin.

It's also known as dermatitis (skin inflammation), atopic eczema ("atopic" means a genetic tendency toward allergic hypersensitivity), or simply atopic dermatitis.

In fact, the word "eczema" is often used interchangeably with "atopic dermatitis,” though clinically speaking, atopic dermatitis is the most common type of eczema.

These include:

Contact Eczema (Contact Dermatitis)

Hand Eczema

Dyshidrotic Eczema

Small, itchy blisters on the soles of the feet and edges of the fingers, toes, and palms may be signs of dyshidrotic eczema. Stress and allergies are two possible triggers for this form of eczema.

Nummular Eczema

Compared to other types of eczema, nummular eczema appears differently: as itchy, coin-shaped spots on the skin.

Stasis Dermatitis

This occurs when fluid leaks out of the veins and into the skin due to blood flow issues.

Seborrheic Dermatitis

Seborrheic dermatitis happens when white or yellow scaly patches of skin develop in oily areas, such as the scalp (as dandruff), face, and earspartly as a result of microorganisms that live on the skin (such as some types of yeast).

Learn More About Types of Eczema

People with eczema have very dry, itchy skin and rashes on various parts of the body — particularly the face, hands, feet, insides of the elbows, and behind the knees.

In addition, skin lesions and blotches may develop on the wrists, ankles, sides of the neck, or around the mouth.

For most people, the main symptom of eczema is itching, which can lead to scratching and rubbing that further irritates the skin. This can, in turn, lead to the “itch-scratch cycle” or increased itching and scratching that worsens eczema symptoms.

Other skin symptoms associated with eczema include:

• Rough, leathery patches of skin
• Red, raised bumps (hives)
• Increased skin creases on the palms of the hands
• Small, rough bumps on the face, upper arms, and thighs
• Scaly skin patches
• Swollen, sore skin
• Skin color changes

Learn More About Signs and Symptoms of Eczema

Skin affected by eczema is unable to retain moisture well, possibly because of low production of fats and oils. It is also caused by a disrupted skin barrier, allowing whatever moisture the skin has to freely evaporate into the air. This causes it to become dry and lose its protective properties.

It's not clear what causes certain people to develop eczema, specifically atopic dermatitis.

Children are more likely to develop eczema if other allergic diseases — such as hay fever and asthma — run in the family, which suggests that there may be a genetic component to the condition. Read more about conditions related to eczema below.

Though dermatologists don’t necessarily consider eczema an autoimmune disorder, the symptoms of atopic dermatitis are thought to be the result of an immune system overreaction or dysfunction.

In addition to genetic and immune system factors, environmental factors also play a role in worsening or triggering eczema.

• Soaps, detergents, shampoos, and dishwashing liquids
• Bubble bath liquids
• Dust or sand
• Cigarette smoke
• Perfumes, and skin-care products that contain fragrances or alcohol
• Wool or synthetic fabrics
• Chemicals, solvents, and mineral oils
• Mold
• Pollen
• Pet dander
• Allergenic foods (such as peanuts, soy, and eggs)
• Dust mites
• A hot or dry climate
• High or low humidity
• Bacterial, viral, or fungal infections

In some cases, eczema symptoms are confused with insect bites or allergic reactions.

Learn More About Eczema Causes and Risk Factors

To diagnose eczema, your doctor will first conduct a physical examination to look at the state of your skin and see if you have the characteristic rash of the illness.

They may perform a skin biopsy (remove a skin sample for examination) to confirm the diagnosis and rule out other skin conditions.

Prognosis of Eczema

But about one-half of adults with atopic dermatitis had it as a child.

Atopic dermatitis in adults often lasts a long time and there is no way to determine if it will go away or last a lifetime. But the frequency and severity of symptoms usually decrease over time, and you can control atopic dermatitis through treatment, moisturizing, and by avoiding irritants that cause flare-ups.

There is no cure for eczema, and the goal of treatment is to reduce eczema symptoms, heal the skin, and prevent skin damage and flare-ups.

Medication, moisturizers, and at-home skin-care routines make up an effective treatment plan for many people who live with eczema.

Medication Options

• Topical corticosteroids (ointments, creams, or lotions) that include drugs such as Vanos (0.1 percent fluocinonide) cream, and come in varying degrees of strength
• Topical calcineurin inhibitors (TCIs), like Protopic (tacrolimus) and Elidel (pimecrolimus)
• The topical PDE4 inhibitor Eucrisa (crisaborole)
• Antihistamines, such as Benadryl (diphenhydramine), hydroxyzine, or Unisom (doxylamine succinate), which help with sleep issues and may help prevent nighttime scratching
• Oral immunosuppressants, like Neoral, Sandimmune or Restasis (cyclosporine), Trexall or Rasuvo (methotrexate), or CellCept (mycophenolate)
• The self-administered injectable drug Dupixent (dupilumab)
• Antibiotic, antiviral, or antifungal drugs to treat any skin infections
• Opzelura (ruxolitinib), a JAK (Janus kinase) inhibitors cream for treating mild to moderate atopic dermatitis in patients age 12 years and older who can’t use other topical treatments or don’t get enough symptom relief from other therapies

Diet Options

Elimination diets are also used to diagnose autoimmune conditions such as eosinophilic esophagitis (EoE), a chronic disease of the esophagus, according to the American College of Gastroenterology.

Alternative and Complementary Therapies

Learn More About Treatment for Eczema: Medication, Alternative and Complementary Therapies, Diet Changes, and More

Prevention of Eczema

There is no proven way to prevent getting eczema. Nonetheless, research suggests children who are breastfed until they’re 4 months old may be less likely to get it. Alternatively, partially hydrolyzed formula, which contains processed cow milk protein, may also reduce a child's chance of developing atopic dermatitis.

• Follow a healthy skin-care routine, including using moisturizing cream or ointment two to three times a day.
• Use gloves when needed, such as when you’re at risk of coming in contact with irritants. That means while working outside or if you have to put your hands underwater (to absorb sweat, wear cotton gloves under plastic gloves).
• Bathe smart, such as by using only mild soap and lukewarm water for your bath or shower, and patting your skin dry instead of rubbing it.
• Stay cool by drinking lots of water, and avoiding getting hot and sweaty.
• Wear loose clothes — that is, those that are made of cotton and other natural materials.
• Keep your body temperature steady by avoiding sudden changes in temperature and humidity.
• Tame stress by recognizing the signs and taking steps to manage it.
• Limit exposure to known irritants and allergens as best you can.
• Don't itch affected skin areas.

People with eczema are at risk of developing infections if they scratch themselves so much that they break the skin.

Learn More About Eczema Complications

Eczema can occur at any age, but it typically begins in infancy and early childhood.

National survey data suggest the one-year prevalence of atopic dermatitis among American adults was 10.2 percent in 2010 and 7.2 percent in 2012. But the surveys used different questions: The former referred to "dermatitis, eczema, or any other red, inflamed skin rash" and the latter to "eczema or skin allergy."

Furthermore, skin infections due to a compromised skin barrier may affect people with eczema. They include:

• Staph infections (and furuncles or boils)
• Eczema herpeticum
• Cellulitis
• Impetigo

Favorite Orgs for Essential Info About Eczema (Atopic Dermatitis)

National Eczema Association (NEA)

The NEA is the most prominent U.S. organization devoted solely to education, research, patient support, and advocacy related to atopic dermatitis and other forms of eczema. We love their eczema fact sheets, glossary of skin-care terms, and informative webinars. Plus, they have a yearly family-friendly Eczema Expo each summer at a vacation destination.

National Eczema Society (NES)

This society is one of the most visible resources in the United Kingdom to educate people about eczema, provide help for people with the disease, and support research. Perhaps their most unique resource is a confidential telephone and email hotline that people in the United Kingdom can call Monday through Friday, 8 a.m. to 8 p.m. local time.

How to Take a Bath if You Have Eczema-Prone Skin

Favorite Orgs for Essential Info About Skin and Allergic Diseases, Including Eczema

American Academy of Dermatology (AAD)

The AAD says it is the largest professional dermatologic association, with more than 20,500 physicians as members worldwide. They publish information about a variety of skin conditions, and we recommend checking out the robust resource center with information about childhood and adult eczema.

Favorite Sites for Eczema Relief Products

AAFA Store

Find household products that are certified “Asthma & Allergy Friendly,” and therefore less likely to trigger eczema flare-ups, through the Asthma and Allergy Foundation of America’s online store.

NEA Store

The National Eczema Association has an online store of sensitive skin–friendly products that bear the NEA Seal of Acceptance, meaning they are intended for people with moderate to severe skin conditions. Get moisturizers, cleansers, detergents, and other items designed to protect and not irritate your skin.

Favorite Resource for Diet Advice

Elimination Diets — NEA on Eczema and Food Allergies

Avoiding food allergy triggers may help you manage eczema, but sometimes you need help identifying precisely what the triggers are. This is where an elimination diet may help. This approach involves omitting a food you think is problematic and then reintroducing it to see what happens. We love this article with information from the dermatologist Peter Lio, MD, which delves into some of the misconceptions about the diet, as well as the link between eczema and what you eat.

Favorite Resource for Becoming an Advocate

NEA Advocacy Action Center

We love that the NEA has made it so easy to advocate for better healthcare policies. Their Advocacy Action Center enables people to browse legislation related to eczema in various states. If you wish to “take action,” you can click on a button and fill out an online form to send a message to your local lawmaker.

Favorite Eczema Tracking App

Eczema Tracker

Information is power when it comes to managing eczema symptoms and flare-ups. Eczema Tracker allows you to take a photo of flare-ups and monitor your condition, as well as track and analyze a wealth of information concerning your triggers, allergies, and skin. The app even provides local pollen, weather, mold, and humidity information to help you manage your symptoms. It uses your data to find trends that may lead to flare-ups. Eczema Tracker is available only for iOS in the Apple Store. It is a free app.

Is Turmeric Helpful for Treating Eczema?

Favorite Eczema Spa Retreat

Eczema Expo Spa Treatments

Participants in the 2019 NEA Eczema Expo were able to enjoy spa treatments at a local day spa in consultation with a dermatologist who could help them to choose the best treatments for their skin condition. We hope they will do this again in 2020!